자동차상해 약관상 산재보험금 공제조항에 관한 연구 - 대법원 2020. 5. 14. 선고 2016다244538 판결 -

A self physical accident insurance policy is an insurance item to compensate damage based on terms when the insured dies or is injured in a car accident while owning, using, or managing an insured vehicle as prescribed by the terms and conditions. The industrial accident insurance deductible clause in the accident we talked about in this paper was deleted in this selling insurance terms now. However, it is regarded as the industrial accident insurance deductible clause is still valid because the insured stipulates "the amount already paid" or "the amount compensated" from a third party other than the liability. In this case, the Supreme Court judged the original trial was reasonable which paid amount deducting exclusion amount from insurance amount because deductible clause is a kind of private contact under freedom of contact rule so it is not an unfair clause. A self physical accident insurance belongs to accident insurance by its characteristic, but industrial accident insurance has the characteristic of liability insurance for employer's accident compensation, so it cannot be considered as double compensation legally because the legal nature or purpose of the insurance contract is different. and It is regrettable that a harmonious interpretation would have been possible if we kept in mind the fact that the principle of freedom of contract may be limited because the insurance contract law has the characteristics of relative compulsory legality along with public and social characteristics. In addition, the amount of insurance money was reduced as a result of incorrect deduction from the guarantee insurance amount even though the industrial accident insurance money deductible clause had to be deducted from the actual loss in the court. Therefore, this paper examined the interpretation and scope of the industrial accident insurance deductible clause, whether the industrial accident insurance deductible clause is invalid under the Terms and Conditions Regulation Act, and whether it is obligated to specify and explain. and the calculation of a self physical accident insurance money was classified separately and the reason why insurance monry were underestimated due to the wrong order of application of the target judgment was examined. This is to ensure that automobile insurance fulfills the social function of victim protection by preventing insurance companies from underpaying insurance amount for large size accidents exceeding the guarantee insurance amount.